PB1908: COVID-19 INSIGHTS IN PATIENTS WITH CHRONIC MYELOID LEUKEMIA: DIAGNOSIS AND TREATMENT
Authors: V. Musteata
Journal: HemaSphere (2022)

Background: The recent published reports pointed to the increased incidence of COVID-19 in patients with hematologic neoplasms as compared to the apparently healthy population. The growing incidence of COVID-19 and chronic myeloid leukemia (CML) in a workable population may be considered as an important issues of hematooncology and public health. Aims: The aim of the study was the determination and assessment of the current epidemiological and diagnosis features of COVID-19 in patients with CML in order to adjust the management of this hematologic malignancy Methods: We realized the analytical, observational and prospective study of a group of 17 patients with CML, who were treated and followed up in the Institute of Oncology from the Republic of Moldova between 2005–2021. COVID-19 was diagnosed between March 2020 – November 2021 only in these 17 patients out of the whole cohort of CML cases treated with tyrosine kinase inhibitors (TKIs). The quantitative reverse transcription polymerase chain reaction (RT-PCR) was accomplished with the aim to determine the expression of the BCR-ABL p210 and p190 transcripts. Nucleic acid amplification testing with a RT-PCR assay was performed in order to detect SARS-CoV-2 RNA from the upper respiratory tract, as the preferred initial diagnostic test for COVID-19. The study assessed the impact of Sokal score on COVID-19 morbidity in CML patients. Results: These 17 cases constituted 11.9% of 142 patients diagnosed with CML and followed up under the treatment with TKIs. There were 10 (58.8%) males and 7 (41.5%) females, with the male:female ratio 1.4:1. The patients’ age at diagnosis of COVID-19 ranged between 38-74 years (average age 52.3 years). Seven (41.5%) patients were under 50 years of age, 10 (58.8%) patients were over 50 years, and 6 of them were over 60 years of age. According to the WHO classification of COVID-19 severity, mild forms were registered in 4 (23.5%) cases, moderate in 8 (47.1%) and severe in 5 (29.4%) cases. The ECOG score of performance status of CML patients ranged between 0-2 at the time of diagnosis of COVID-19. The ECOG score was 2 only in 2 (12.5%) patients, who experienced severe COVID-19. SARS-CoV-2 affected 8 (50.0%) low-risk patients, 5 (31.3%) intermediate-risk and 3 (18.7%) high-risk patients. COVID-19 developed in 14 (82.4%) patients with complete hematologic response and in 3 (17.6%) patients without stable response to treatment with TKIs. Nine (52.9%) patients were hospitalized for treatment of COVID-19, including all 5 (29.4%) with severe and 4 (23.5%) with moderate forms. Viral pneumonia was diagnosed by radiological examinations in 7 (41.2%) patients, including 5 (29.4%) with severe and 2 (11.8%) with moderate COVID-19. Non-infectious comorbidities were registered in 4 of 5 patients with severe COVID-19 form. Summary/Conclusion: COVID-19 affected commonly CML patients of male gender. The older CML patients were more susceptible to COVID-19. Sokal score did not influence the COVID-19 morbidity in CML patients. Severe SARS-CoV-2 infection occurred in CML patients with serious non-infectious comorbidities. Patients with accelerated and acute phases exhibited the unfavorable correlative evolution of CML and COVID-19.